2000 Hastada Konjenital Mediastinial Vasküler Anomoli Tiplerinin ve Sıklığının Değerlendirilmesi.

Yıl 2022, , 15 - 20, 27.03.2022

Yeliz Dadalı , Sercan Özkaçmaz , Mustafa Demir , İlke Bursalı

https://doi.org/10.30565/medalanya.939714

Öz

Amaç: Toraksın konjenital vasküler anomalileri çok sık olmayıp sıklıkla asemptomatiktirler ve görüntülemelerde tesadüfen saptanırlar. Bu çalışmamızda bölgemizde konjenital mediastinal vasküler anomalilerin sıklığını araştırmayı planladık.

Yöntem: Yaklaşık 2 yıllık bir süreçte non-spesifik semptomlar ile kontrastlı toraks Bilgisayarlı Tomografi (BT) çekilen hastaların özellikleri hastane veri tabanından retrospektif olarak tarandı. Yaş ve cinsiyet gibi demografik özellikler kaydedildi. Tüm Bilgisayarlı Tomografi (BT) BT görüntüleri, persistan sol superior vena kava, azygos lobu, aberran sağ subklavien arter, dilate sol superior interkostal ven, sağ taraflı arkus aorta, situs inversus ve parsiyel anormal pulmoner venöz dönüş anomalileri açısından yorumlandı. Çalışmamızda bulunan insidans değerleri ile önceki çalışmaların sonuçları karşılaştırıldı.

Bulgular: Nihai olarak ortalama yaşı 56.13±14.62 (12-93 yıl) olan 2000 hasta çalışmaya dahil edildi. Bunların 776 (%38.8) tanesi kadın (ortalama yaş 56.93±15.19 (13-93 yıl)) ve 1224 (% 61.2) tanesi erkekti (ortalama yaş 55.63±14.23 (12-88 yıl)). Mediastinal vasküler anomali 62 (%3.1) hastada saptandı. Kadın hastaların 27 (%3.5)’inde ve erkek hastaların 35 (%2.6) ’inde bir mediastinal vasküler anomali gözlemlendi. Çalışmamızdaki en sık saptanan mediastinal vasküler anomali, sağ aberran subklavien arter (n:17, %0.9) ve en nadir görüleni ise parsiyel anormal pulmoner venöz dönüş anomalisi idi (n:1, %0.1). Persistan sol superior vena kava insidansı %0.3 (n:6), azygos lobu %0.7 (n:14), sağ taraflı arkus aorta %0.3 (n:5), situs inversus totalis %0.2 (n:3) ve genişlemiş sol superior interkostal ven ise %0.8 (n:16) olarak bulundu.

Sonuç: Mediastinal vasküler anomaliler nadir olup sıklıkla asemptomatiktir. Ancak bu durumların görüntüleme bulgularının iyi bilinmesi, girişimsel işlemleri doğu biçimde planlamada ve aynı zamanda iatrojenik yaralanmaları önlemede gereklidir.

Anahtar Kelimeler

Bilgisayarlı Tomografi, Bilgisayarlı Tomografi, Parsiyel anormal pulmoner venöz dönüş anomalisi, Sağ aberran subklavien arter, Situs inversus totalis, Genişlemiş sol superior interkostal ven

Evaluation of Congenital Mediastinal Vascular Anomaly Types And Frequencies Among 2000 Cases

Öz

Aim: Congenital vascular malformations of the thorax are not very common. These conditions are mostly asymptomatic and detected incidentally on imaging performed for various complaints. In this study, it is aimed to examine the incidence of congenital thoracic vascular anomalies in our region.

Methods: The features of the patients with non-specific complaints who underwent a thorax Computed Tomography (CT) for over 2 years period were retrospectively reviewed on the hospital database and demographical data (Gender and age) were recorded. All the Computed Tomography CT images were interpreted regarding thoracic vascular anomalies including persistent left superior vena cava, azygos lobe, aberrant right subclavian artery, dilated left superior intercostal vein, right-sided aortic arch, situs inversus, and partial anomalous pulmonary venous return. The incidences of these thoracic vascular anomalies were calculated and compared with previous studies.

Results: A total of 2000 patients with a mean age of 56.13±14.62 (12-93 years) were included in this study. Among them 776 (38.8%) ones were female (mean age 56.93±15.19 (13-93 years)) and 1224 (61.2%) were male (mean age 55.63±14.23 (12-88 years)). Mediastinal vascular anomaly was detected in 62 (3.1%) patients. A mediastinal vascular anomaly was observed in 27 (3.5%) female patients and 35 (2.6%) male patients. The most common mediastinal vascular anomaly inthis study was the right aberrant subclavian artery (n:17, 0.9%) and the rarest was partial anomalous pulmonary venous return (n:1, 0.1%). Persistent left superior vena cava incidence was 0.3% (n:6), azygos lobe 0.7% (n:14), right-sided aortic arch 0.3% (n:5), situs inversus totalis 0.2% (n:3), and dilated left superior intercostal vein 0.8% (n:16).

Conclusion: Mediastinal vascular anomalies are rare and usually asymptomatic. But the imaging findings of these conditions must be well-known to accurately planning the interventions and also to prevent iatrogenic injuries.

Anahtar Kelimeler

Computed Tomography, Computed Tomography, Partial anomalous pulmonary venous return, Aberrant right subclavian artery, Situs inversus totalis, Dilated left superior intercostal vein

Kaynakça

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